Healthcare Provider Details

I. General information

NPI: 1033543236
Provider Name (Legal Business Name): ROSEBETH MARCOU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2013
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 E WEST HWY STE 150
BETHESDA MD
20814-3327
US

IV. Provider business mailing address

4500 E WEST HWY STE 150
BETHESDA MD
20814-3327
US

V. Phone/Fax

Practice location:
  • Phone: 301-202-1224
  • Fax: 855-882-3606
Mailing address:
  • Phone: 301-202-1224
  • Fax: 855-882-3606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License NumberH9679
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License NumberD83514
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License NumberD0083514
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: